US4674505A - Apparatus for the contact-free disintegration of calculi - Google Patents
Apparatus for the contact-free disintegration of calculi Download PDFInfo
- Publication number
- US4674505A US4674505A US06/634,021 US63402184A US4674505A US 4674505 A US4674505 A US 4674505A US 63402184 A US63402184 A US 63402184A US 4674505 A US4674505 A US 4674505A
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- US
- United States
- Prior art keywords
- shock wave
- lens
- wave tube
- convergent lens
- acoustic
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
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Classifications
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- G—PHYSICS
- G10—MUSICAL INSTRUMENTS; ACOUSTICS
- G10K—SOUND-PRODUCING DEVICES; METHODS OR DEVICES FOR PROTECTING AGAINST, OR FOR DAMPING, NOISE OR OTHER ACOUSTIC WAVES IN GENERAL; ACOUSTICS NOT OTHERWISE PROVIDED FOR
- G10K9/00—Devices in which sound is produced by vibrating a diaphragm or analogous element, e.g. fog horns, vehicle hooters or buzzers
- G10K9/12—Devices in which sound is produced by vibrating a diaphragm or analogous element, e.g. fog horns, vehicle hooters or buzzers electrically operated
-
- G—PHYSICS
- G10—MUSICAL INSTRUMENTS; ACOUSTICS
- G10K—SOUND-PRODUCING DEVICES; METHODS OR DEVICES FOR PROTECTING AGAINST, OR FOR DAMPING, NOISE OR OTHER ACOUSTIC WAVES IN GENERAL; ACOUSTICS NOT OTHERWISE PROVIDED FOR
- G10K11/00—Methods or devices for transmitting, conducting or directing sound in general; Methods or devices for protecting against, or for damping, noise or other acoustic waves in general
- G10K11/18—Methods or devices for transmitting, conducting or directing sound
- G10K11/26—Sound-focusing or directing, e.g. scanning
- G10K11/30—Sound-focusing or directing, e.g. scanning using refraction, e.g. acoustic lenses
Definitions
- the invention relates to a facility for the contact-free disintegration of a calculus located in the body of a living being and comprising a shock wave generator which can be directed to a target region in the body.
- Facilities of this type are employed in medicine, for example for the pulverization of stones in the kidney of a human being. They are particularly advantageous because they avoid any and all surgical intervention in the body. It is not necessary to proceed surgically. The application of probes and devices to the calculus is likewise eliminated. A hazard due to infections or injuries, for example upon introduction of the probe or given surgical operations, cannot occur in the case of contact-free pulverization.
- a facility of the type initially mentioned is disclosed in the German AS 23 51 247 (U.S. Pat. No. 3,942,531).
- a spark discharge is initiated between two electrodes at a first focus in a focussing chamber that is designed as a hemispherical ellipsoid of revolution.
- Said spark discharge causes a shock wave whose wave front propagates at all directions, i.e. spherically.
- the waves are reflected at the wall of the ellipsoid of revolution. They collect at the second focus of the elliptical reflector.
- the reflected waves arrive simultaneously at the second focus at which the calculus is located.
- the calculus is shattered under the focussed impact of the shock waves.
- the coupling between the one ellipsoid half and the body in which the calculus is located occurs via a thin film which presses against the body free of an air gap.
- the focussing chamber is filled with water.
- This facility involves the disadvantage that changes in the shock wave energy are only possible within narrow limits and only with a considerable apparatus outlay by means of changing the spacing of the underwater electrodes. It is further disadvantageous that the mutual spacing of the electrodes must usually amount to a number of millimeters in order to generate high-intensity shock waves, the shock wave source therefore not having a punctiform geometry and imaging errors therefore possibly occurring in the focussing. Further, the underwater electrodes wear greatly with every discharge, so that their service life is limited, this requiring regular servicing of the facilities.
- the object of the present invention is to increase the operating reliability, to obtain an imaging onto a target area with the smallest possible imaging error and to reduce maintenance requirements.
- shock wave tube which is known per se (see Eisenmenger reference) and essentially generates a planar shock wave is provided as the shock wave generator; and in that a lens arrangement which focusses the shock wave onto a focal point in the target region is allocated to the shock wave tube.
- shock wave generator which generates planar waves
- Imaging errors are thereby less probable than when spherical waves emanating from a spark gap region and proceeding in all directions must be focussed.
- the chronological and spatial reproducibility of the shock wave is significantly improved given generation thereof with a shock wave tube in comparison to generation with a spark gap. Maintenance work that arises due to wear and consumption of the electrodes of a spark gap is also eliminated.
- a shock wave tube generates the shock waves with the assistance of electromagnetic forces and does not require a spark gap.
- a shock wave tube is constructed such that it contains a copper membrane at the one end of a fluid-filled, preferably water-filled tube, said copper membrane, separated by an insulating film, being disposed in front of a flat (or pancake) coil.
- the copper membrane is repelled from the flat coil on the basis of a current pulse therein and thereby generates the shock wave in the fluid.
- the copper membrane itself and the tube section adjacent thereto are usually placed at a common reference potential, i.e. they are grounded. High voltage is therefore not adjacent to the coupling agent which conducts the shock wave, the electrical safety of the patient and personnel being thereby increased.
- FIG. 1 shows a longitudinal section through a disintegration facility according to the invention, comprising a convergent lens
- FIG. 2 shows a longitudinal section through a disintegration facility according to the invention, comprising a system of acoustic lenses.
- a known shock wave tube 1 comprised of a jacket 2, of a flat (or pancake) coil 3 having two electrical terminals 5 and 7, of an insulating film 9, of a copper membrane 11 and of a metallic tube section 13 is placed in front of an acoustical convergent lens 15 which has a focal point F.
- the tuve section 13 is filled with a fluid 14, for example water.
- the shock wave tube 1 is coupled to a body 19 via a coupling agent 17 having water-like acoustical properties.
- the body 19 of, for example, a patient has a calculus or concrement 23 in its kidney 21, e.g. a kidney stone.
- the convergent lens 15 is displaceable relative to the jacket 2 of the shock wave tube 1 in opposite longitudinal directions as indicated by double arrows 25 via a fine adjustment means 24 comprising pin 24a and locking wheel 24b.
- the pin 24a is guided in a slot-shaped guideway 24c in the jacket 2 so as to provide for a range of adjustment corresponding to the longitudinal dimension of the slot forming guideway 24c.
- the shock wave tube 1, the convergent lens 15 and the fine adjustment means 24 are mounted on a common stand, tripod or mounting plate.
- a mounting plate 26 is attached to a support 26a so that plate 26 can be universally pivoted in all directions at a universal joing 26b, the support 26a also providing for adjustment of the plate 26 in all directions parallel to supporting surface S, as well as perpendicularly to this surface.
- the shock wave tube 1 can be aligned with the calculus 23 such that the focal point F lies within the calculus 23.
- the copper membrane 11 and the tube section 13 are electrically connected to a safety potential such as ground 27, as is the terminal 7 of the flat coil 3.
- the other terminal 5 of the flat coil 3 is connected to a supply and control unit 33 via a switch 29 which includes an auxiliary contact 31.
- a high voltage U is generated in the supply and contol unit 33 via a capacitor/resistor circuit (not shown). Said high voltage can amount to several kilovolts, for example 20 kV. The voltage U can thereby be varible.
- a control signal which is applied by the supply and control unit 33 to the auxiliary contact 31 via a control line 35 effects the closing of the switch 29 (to form an electrically conductive path between terminals 29a and 5).
- a part of the energy stored in the capacitor (not shown) of the supply and control unit 33 then discharges suddenly into the flat coil 3 which very quickly builds up a magnetic field.
- a current is induced in the copper membrane 11, said current being directed opposite the current in the flat coil and generating an opposing magnetic field.
- the copper membrane 11 is repelled from the flat coil 3 due to the dynamic effect of the opposing magnetic fields.
- This repulsion of the copper membrane 11 generates a planar shock wave, i.e. a sudden compression in the fluid 14 situated in front of the membrane 11.
- This shock wave has a steep rise in pressure, for example to 200 bar.
- the shock wave increases in steepness on its path through the tube section 13, the convergent lens 15 and the body 19 of the patient. In other words, the slewing rate or rate of raise of the shock wave increases on its path to the concrement 23. After passing through the convergent lens 15, the shock wave is directed such that it converges at the focal point F.
- the calculus 23 is placed there, and the focussed shock wave emits part of its energy content to the calculus 23 by means of tensile or compression forces, said calculus 23 being brittle in comparison to its environment. These forces decompose the calculus 23 into a number of parts and thus effect its disintegration.
- This irradiation process must be repeated a number of times depending on the size and consistency of the calculus 23.
- the shock wave tube 1 in the present embodiment has a diameter of approximately 100 mm and a length of approximately 150 mm. Also shorter shock wave tubes having a length of e.g. about 10 mm may be employed.
- the disclosed disintegration facility offers the considerable advantage that the grounded copper membrane 11 and the grounded tube section 13 do not represent a source of hazard to the patient 19 or to the operating personnel.
- the electrical safety of the facility can even be increased for the operating personnel by means of an additional, insulating encapsulation (not shown), for example in the form of a synthetic coating of the outer surface of the jacket 2.
- Two-fold protection of the patient 19 against the electric high voltage derives given employment of a sack 37 filled with the coupling agent 17 at the place of entry of the shock wave into the patient 19. This protection is defined, on the one hand, by the insulating sack wall and, on the other hand, by the insulating film 9 in front of the flat coil 3.
- the switch 29, moreover, can be integrated in the supply and control unit 33. It can also be placed at a distance from the shock wave tube arrangement. Since a spark gap need not be necessarily employed for the initiation, namely, vacuum switches or, more recently, SF-6 switches also, for example, come into consideration, the involved maintenance and service work that would be connected with the spark gap are eliminated.
- FIG. 2 shows a known shock wave tube 1 to which a system 40 of acoustic lenses for imaging a planar shock wave onto a calculus 23 in the body of a patient 19 is allocated.
- the system 40 of acoustic lenses is comprised of a dispersing lens 42, of a condensor lens 44 and of a convergent lens 46 having a focal point F.
- the preferred material for the system 40 of acoustic lenses in plexiglass or polystyrene.
- the planar shock wave generated in the shock wave tube 1 is expanded in cross-section by the dispersing lens 42.
- the shock wave is aligned parallel by means of the condensor lens 44 and is focussed onto the focal point F by means of the convergent lens 46.
- the advantage of this exemplary embodiment is that the shock wave enters into the body 19 of the patient over a larger cross-section of the body surface. As a result thereof, it is possible to keep the energy density in the tissue of the patient low, particularly at the body surface 48.
- the shock wave tube may comprise a carrier 49 for the spirally wound pancake coil 3-A.
- the electrical energizing system for coil 3-A may be the same as shown for the spirally wound coil 3 in FIG. 1.
- Reference numeral 9-A in FIG. 2 may represent a disk-like insulating foil or film of minimum thickness so as to be comparable to the insulating layer 9 in FIG. 1.
- the flat coil 3, the insulating film 9 and the copper membrane 11 should be arranged close to each other in order to achieve a maximum emission effect.
- the interface indicated in FIG. 1 between components 3 and 9, 13 merely for a clear illustration of the individual components should be avoided.
- the disk-like copper membrane 11-A in FIG. 2 may be grounded along with the cylindrical tube section 13-A.
- the parts 11-A, 13-A and 42 form a leak-tight chamber for receiving a fluid 14-A such as water.
- the jacket 13-A may be sealed to a wall of a water tank at an aperture in such wall using a flexible water proof coupling analogous to coupling 37, FIG. 1, so that the system 49, 3-A, 9-A, 11-A, 13-A, 42, 44 and 46 is universally pivotal relative to the water tank.
- an open frame would connect parts 13-A, 42, 44 and 46 for joint horizontal displacement as represented by double arrow 25 as well as universal pivotal adjustment while the exterior of lens 42, and the lenses 44 and 46 remain immersed in the water tank along with body surface 48.
- element 24a may be secured to the lens 15 and may be externally threaded so that nut element 24b with internal threads may be tightened thereon to clamp the lens 15 at a selected longitudinal position.
- Tube 13 may be cylindrical, and lens 15 may have mating cylindrical external surface fitting slidably within tube 13.
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- Physics & Mathematics (AREA)
- Engineering & Computer Science (AREA)
- Acoustics & Sound (AREA)
- Multimedia (AREA)
- Surgical Instruments (AREA)
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE3328051 | 1983-08-03 | ||
DE19833328051 DE3328051A1 (de) | 1983-08-03 | 1983-08-03 | Einrichtung zum beruehrungslosen zertruemmern von konkrementen |
Publications (1)
Publication Number | Publication Date |
---|---|
US4674505A true US4674505A (en) | 1987-06-23 |
Family
ID=6205689
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US06/634,021 Expired - Lifetime US4674505A (en) | 1983-08-03 | 1984-07-24 | Apparatus for the contact-free disintegration of calculi |
Country Status (3)
Country | Link |
---|---|
US (1) | US4674505A (de) |
EP (1) | EP0133665B1 (de) |
DE (2) | DE3328051A1 (de) |
Cited By (117)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4766888A (en) * | 1986-07-14 | 1988-08-30 | Siemens Aktiengesellschaft | Shock wave generator for an apparatus for non-contacting disintegration of calculi in the body of a life form |
US4782821A (en) * | 1986-07-14 | 1988-11-08 | Siemens Aktiengesellschaft | Shock wave generator for an installation for non-contacting disintegration of calculi in the body of a life form |
US4793329A (en) * | 1986-10-06 | 1988-12-27 | Siemens Aktiengesellschaft | Shock wave source |
US4796608A (en) * | 1986-06-16 | 1989-01-10 | Siemens Aktiengesellschaft | Shock wave generator for an apparatus for non-contacting disintegration of calculi in the body of a life form |
US4811725A (en) * | 1986-12-22 | 1989-03-14 | Siemens Aktiengesellschaft | Extracorporeal lithotripsy apparatus |
US4813402A (en) * | 1986-02-19 | 1989-03-21 | Siemens Aktiengesellschaft | Coupling member for a shock wave therapy device |
US4813415A (en) * | 1986-08-18 | 1989-03-21 | Siemens Aktiengesellschaft | Sensor for evaluation of shock wave pulses |
US4821245A (en) * | 1986-10-09 | 1989-04-11 | Richard Wolf Gmbh | Electromagnetic transducer |
US4836191A (en) * | 1987-01-26 | 1989-06-06 | Siemens Aktiengesellschaft | Lithotripsy work station |
US4838248A (en) * | 1986-12-22 | 1989-06-13 | Siemens Aktiengesellschaft | Shock wave head for non-contacting disintegration of calculi |
US4844079A (en) * | 1986-10-23 | 1989-07-04 | Siemens Aktiengesellschaft | Lithotripter comprising locating apparatus |
US4901709A (en) * | 1987-07-07 | 1990-02-20 | Siemens Aktiengesellschaft | Shock wave source |
US4920955A (en) * | 1986-10-06 | 1990-05-01 | Siemens Aktiengesellschaft | Shock wave source |
US4928671A (en) * | 1986-07-16 | 1990-05-29 | Siemens Aktiengesellschaft | Shock wave generator for generating an acoustical shock wave pulse |
US4928672A (en) * | 1987-07-31 | 1990-05-29 | Siemens Aktiengesellschaft | Shockwave source having a centrally disposed ultrasound locating system |
US4945898A (en) * | 1989-07-12 | 1990-08-07 | Diasonics, Inc. | Power supply |
US4947830A (en) * | 1988-02-16 | 1990-08-14 | Siemens Aktiengesellschaft | Shock wave generator for extracorporeal lithotripsy |
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US5005579A (en) * | 1987-02-17 | 1991-04-09 | Richard Wolf Gmbh | Apparatus for spatial location and destruction of objects inside the body by means of ultrasound |
US5009232A (en) * | 1988-08-17 | 1991-04-23 | Siemens Aktiengesellschaft | Extracorporeal lithotripsy apparatus using high intensity shock waves for calculus disintegration and low intensity shock waves for imaging |
US5014969A (en) * | 1989-06-30 | 1991-05-14 | Siemens Aktiengesellschaft | Patient supporting table having a support plate provided with a cut-out and having a base member carrying the support plate |
USRE33590E (en) * | 1983-12-14 | 1991-05-21 | Edap International, S.A. | Method for examining, localizing and treating with ultrasound |
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US5029826A (en) * | 1989-06-30 | 1991-07-09 | Siemens Aktiengesellschaft | Patient supporting table with a support plate provided with a cut-out |
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DE4034533C1 (de) * | 1990-10-30 | 1992-01-30 | Siemens Ag, 8000 Muenchen, De | |
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Also Published As
Publication number | Publication date |
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EP0133665A2 (de) | 1985-03-06 |
EP0133665A3 (en) | 1985-04-03 |
DE3472209D1 (en) | 1988-07-28 |
EP0133665B1 (de) | 1988-06-22 |
DE3328051A1 (de) | 1985-02-14 |
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